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PubMed1985

Counseling patients to counsel physicians on future care in the event of patient incompetence.

Physicians and patients share a common interest in clarifying and maximizing the powers and protection of advanced directives for future care in the event of patient incompetence. Although the complexity and unpredictability of health care circumstances make it impossible to guarantee complete control over therapeutic measures to be used when survival is in question, physicians should offer their patients the opportunity to reflect on their values and wishes and to express them explicitly. The ideal advanced directive should clearly state the author's intentions; contain clear documentation regarding authorship; be flexible, allowing family and caregivers to respond appropriately to changing circumstances; be available when needed; and be supported by legal powers that grant patients the right of enforcement and grant health care providers protection from liability. Advanced directives can be set as instruction directives or proxy directives, each form having advantages and disadvantages.

Attitude to Health↗
PubMedDate not supplied

[Interdisciplinary cooperation: experiences from the model project "Development of Counseling Criteria for Counseling Pregnant Patients Expecting a Handicapped Child"]].

The three-year model project "Development of consultation criteria in consulting pregnant women expecting a child with possible birth defects" aimed above all at constructing an interdisciplinary cooperation to offer the possibility of a psycho-social consultation to women and couples who are put under pressure of decision after prenatal examinations. The intended interdisciplinary cooperation between physicians and psycho-social consultation centres which are independent of the medical system resulted to be especially difficult due to the fact that various cooperation impediments stood against the construction of regular working relationships. Most of all, the differentiation of the various definitions of medical and psycho-social consultation and the relevant tasks seem to be evaluated differently by the individual profession groups. Moreover, it is not yet possible to make compatible the special working structures of the profession groups, i.e. in the medical public health system, hierarchical structures are prevailing while psycho-social consultation in free bodies bases on the voluntariness of its use. Thus, a cooperation between psycho-social consultation centres for pregnant women and clinics and established gynecologists was possible in a few cases only.

Congenital Abnormalities↗